Cardiovascular disease outcomes in metabolically healthy obesity in communities of Beijing cohort study

Abstract

Summary Objective The objective of this study was to investigate the association between metabolically healthy obese (MHO) phenotype and the risk of cardiovascular disease (CVD). Methods A total of 9393 subjects aged ≥40 years were enrolled in the cohort study (2011‐2015). The participants were stratified by body mass index category and metabolic risk at baseline, and incidence of CVD was ascertained at follow‐up. Results The MHO accounted for 6.7%. Compared with the metabolically healthy normal weight (MHNW) group, MHO subjects demonstrated increased risk of CVD events (HR = 1.91; 95% CI, 1.13‐3.24). In people with obesity, there was no significant difference on increasing risk of incidence of CVD in the metabolically unhealthy individuals compared with metabolically healthy individuals (HR = 1.19; 95% CI, 0.74‐1.91). Female (OR = 1.97; 95% CI, 1.06‐3.64), smoking (OR = 2.09; 95% CI, 1.06‐4.10), a larger waist circumference (OR = 1.07; 95% CI, 1.03‐1.10) and higher LDL cholesterol levels (OR = 1.55; 95% CI, 1.20‐2.00) were independent risk factors of the development of the MHO to the metabolically unhealthy obese (MUO) phenotype. Conclusions The risk of CVD events of MHO phenotypes is similar to MUO phenotypes; both are higher than the MHNW phenotypes.

Metabolically healthy obesity, transition to unhealthy metabolic status, and vascular disease in Chinese adults: A cohort study

“…However, no Asian studies were included in this meta-analysis. More recently, the Beijing Cohort Study [ 18 ] and the China Health and Retirement Longitudinal Study [ 19 ], including 9,393 and 7,849 Chinese adults, showed that MHO individuals had a higher risk of CVD (HR 1.91 [1.13–3.24] and 1.33 [1.19–1.49]) than MHN ones. However, both studies have a smaller sample size and shorter follow-up time than ours, with very few cases in subgroups.…”

“…Furthermore, a meta-analysis demonstrated that such increased CVD risk of MHO individuals is considerably lower than that of individuals with metabolically unhealthy obesity (MUO) [ 17 ]. However, these estimates were mostly from Western populations, with little evidence from China [ 18 , 19 ], where adiposity distribution, risk of obesity, lifestyle, and disease patterns differ substantially from those in Western populations [ 20 – 22 ]. Importantly, the Western cohort studies demonstrated that metabolic health changed over time across body mass index (BMI) categories and was associated with cardiovascular risk [ 9 , 23 ].…”

Obesity phenotypes and the risk of myocardial infarction: a prospective cohort study

“…Известно, что приблизительно 10-30% людей с ожирением метаболически здоровы, несмотря на чрезмерное накопление жира в организме [2,3]. Недавние обсервационные исследования показывают, что метаболически здоровый фенотип ожирения (MЗФО) связан с более низким риском в отношении сердечно-сосудистых заболеваний (ССЗ) и смертности у лиц с метаболически нездоровым фенотипом ожирения (МНФО) [4], особенно у тех, кто физически активен [5], хотя не все исследования могут подтвердить эти результаты [6]. В частности, в 2017г было опубликовано масштабное проспективное когортное исследование, проведенное в Великобритании с включением 3495777 участников, без ССЗ в анамнезе на момент включения в исследование, средний период наблюдения 5,4 года.…”

Gender and age related features of metabolically healthy obesity phenotype prevalence

“…Однако последние данные указывают на то, что ожирение не всегда приводит к неблагоприятным метаболическим ýффектам и все более широко признается, что оно не является однородным состоянием [2]. Приблизительно 10-30% людей с ожирением метаболически здоровы, несмотря на чрезмерное накопление жира в организме.…”